Midway
The Battle of Midway was one of the most significant naval battles in history, taking place over four days in early June of 1942 just six months after the devastating attack on Pearl Harbor. Although outnumbered in terms of both ships and aircraft, the United States Navy prevailed, destroying all of the Japanese carriers and their accompanying aircraft (248 aircraft in total across 4 carriers) and one heavy cruiser involved in the battle. The US Navy lost one carrier, one destroyer, and approximately 150 of 233 aircraft in the battle. Sadly, 307 US servicemen were killed in the battle, with over 3,000 Japanese servicemen perishing on the opposite side.
So... what does this have to do with me and cancer?
On the face of it, a devastating naval battle that occurred 72 years ago has nothing in common with my cancer diagnosis and treatment. But if you dig a little deeper there are at least a few passing similarities.
First off, I have often heard of people "battling cancer", or more sadly "losing their brave fight against cancer". Before I was diagnosed - actually, even for a long time after I was diagnosed - I didn't really see my journey as a battle. It was tough at times and sure it was at least a challenge most of the time, but it wasn't a battle. At worst, I was in hospital for 48 hours. I was fatigued from the radiation that was being blasted into my pelvis, and at the time that seemed like a pretty big deal.
I do feel like I'm in a battle right now. I am battling cancer. I'll win... but it is a battle.
I feel the impact of my chemotherapy every cycle. I have experienced adverse effects that I used to read about as a health professional and think I understood, but now... well, I am living them. I feel the chemotherapy destroying the mucous membranes in my mouth and on my tongue. I feel the near-death of my colon for nearly ten days after each dose of chemotherapy. I feel the bone-deep, weary exhaustion from my body fighting back against the poison that I am willingly being given. I described it as dancing on a knife's edge and it is like that... but it's also definitely a battle between my body and the chemotherapy that I am getting.
The battle continues. I now have a whole raft of new medications to combat the adverse effects I am still having; pantoprazole to fight the gastritis (heartburn) that is caused by the fluorouracil and worsened by the dexamethasone that is used to prevent nausea and vomiting from the oxaliplatin, Magic Mouthwash to combat the mucositis that is caused by fluorouracil, and a prolonged dose of dexamethasone to try to combat the fatigue that is being caused by pretty much everything. But of course the dexamethasone that gives me more energy during the day also makes it nearly impossible to sleep at night so now I have zopiclone to help me get to sleep and... well, you get the idea, right?
Everything that helps also causes adverse effects. Some of those adverse effects are countered by the other medications that I am taking, but then those medications have adverse effects that aren't countered.
It is a battle. And my body is the battleground.
Is the metaphor of a battleground the end of the similarities between my current chemotherapy and adverse effect management regimen and the Battle of Midway? Of course not (y'all know that I have more words to share, right?). Right now, I am midway through my full chemotherapy course.
GIRAJFFOX (try saying that three times quickly) calls for twelve cycles of chemotherapy given every two weeks for patients that have not had capecitabine or fluorouracil with their radiotherapy. But because I did have capecitabine with my radiotherapy, I only need to receive eight cycles given every two weeks. And I'm halfway through cycle four, so I am halfway through my entire therapy. And what's another word for halfway?
Midway.
What else does midway mean though? It means a lot of things, but the thing that springs instantly to my mind is being equidistant between two points. Imagine you are crossing a bridge - a long bridge, long enough that you really can't see the end that you left or the end that you are approaching. You aren't on the solid land on either side of the bridge but you are far enough from the ends that the only thing that you really see is bridge. In that instant, the bridge is everything to you. That's kind of how I feel - like my life before cancer and my life after cancer aren't even visible any more (even if I know they objectively exist) and all I know right now is my life in the midst of the chemotherapy bridge that I am standing on. It's my whole experience right now - side effects and all - and frankly some days it's the only experience I think I will ever have.
That's pretty dark though.
I can't even begin to imagine what it must have been like to be a young sailor or pilot in the Battle of Midway. If I try, really hard, all I come up with is that they must have been very, very scared and focused on the one thing that was trying to kill them in the very moment in which they were reacting, doing their very best to survive no matter the odds. They had been given tools to fight the battle and there were smart people directing the overall plan, but in the end they had to trust their commanders, trust their training and their tools, and above all have faith that they would survive, that they would win the battle. And, despite how hard things have been over the past month, I still have that faith.
I will win this battle.
A dear friend asked how I was doing the other day. I answer these questions with almost brutal honesty now; I told them that while this cycle has not been a walk in the park, it has been much easier than the last one. Midway through my third cycle - about two weeks ago - I felt defeated. I was losing the battle against my side effects and the forces that were fighting the potential cancer in my body were causing unreasonable casualties against the innocent cells in my body. There was one point - it was only for five minutes, but I think I will remember those five minutes for the rest of my life - when I felt like I had surrendered. I was not just losing the battle, I had already lost it. But my army of angels rallied around me led by my amazing wife. She advocated for my care to one of my oncologists and they reduced the dose of fluorouracil that was causing the intolerable GI side effects I was experiencing, plus they added the whole armamentarium of medications that are balancing my side effects to be on the tolerable side of the nasty knife's edge I had been dancing on. My neutrophil count has recovered and was a very respectable 2.69 just prior to my last course of chemotherapy so my bone marrow seems to be holding its own. Even more important than that number, I am happy to report that I am feeling much better than last cycle... even if I still have noticeable and uncomfortable adverse effects from my chemotherapy.
I can weather this battle; there will be no surrender.
The tide of battle has turned. From this point on, my life will get closer to a life without cancer instead of being in the very middle of a life battling cancer. And before too long, my battle with cancer will be part of history rather than my entire experience.
So... what does this have to do with me and cancer?
On the face of it, a devastating naval battle that occurred 72 years ago has nothing in common with my cancer diagnosis and treatment. But if you dig a little deeper there are at least a few passing similarities.
First off, I have often heard of people "battling cancer", or more sadly "losing their brave fight against cancer". Before I was diagnosed - actually, even for a long time after I was diagnosed - I didn't really see my journey as a battle. It was tough at times and sure it was at least a challenge most of the time, but it wasn't a battle. At worst, I was in hospital for 48 hours. I was fatigued from the radiation that was being blasted into my pelvis, and at the time that seemed like a pretty big deal.
I do feel like I'm in a battle right now. I am battling cancer. I'll win... but it is a battle.
I feel the impact of my chemotherapy every cycle. I have experienced adverse effects that I used to read about as a health professional and think I understood, but now... well, I am living them. I feel the chemotherapy destroying the mucous membranes in my mouth and on my tongue. I feel the near-death of my colon for nearly ten days after each dose of chemotherapy. I feel the bone-deep, weary exhaustion from my body fighting back against the poison that I am willingly being given. I described it as dancing on a knife's edge and it is like that... but it's also definitely a battle between my body and the chemotherapy that I am getting.
The battle continues. I now have a whole raft of new medications to combat the adverse effects I am still having; pantoprazole to fight the gastritis (heartburn) that is caused by the fluorouracil and worsened by the dexamethasone that is used to prevent nausea and vomiting from the oxaliplatin, Magic Mouthwash to combat the mucositis that is caused by fluorouracil, and a prolonged dose of dexamethasone to try to combat the fatigue that is being caused by pretty much everything. But of course the dexamethasone that gives me more energy during the day also makes it nearly impossible to sleep at night so now I have zopiclone to help me get to sleep and... well, you get the idea, right?
Everything that helps also causes adverse effects. Some of those adverse effects are countered by the other medications that I am taking, but then those medications have adverse effects that aren't countered.
It is a battle. And my body is the battleground.
Is the metaphor of a battleground the end of the similarities between my current chemotherapy and adverse effect management regimen and the Battle of Midway? Of course not (y'all know that I have more words to share, right?). Right now, I am midway through my full chemotherapy course.
GIRAJFFOX (try saying that three times quickly) calls for twelve cycles of chemotherapy given every two weeks for patients that have not had capecitabine or fluorouracil with their radiotherapy. But because I did have capecitabine with my radiotherapy, I only need to receive eight cycles given every two weeks. And I'm halfway through cycle four, so I am halfway through my entire therapy. And what's another word for halfway?
Midway.
What else does midway mean though? It means a lot of things, but the thing that springs instantly to my mind is being equidistant between two points. Imagine you are crossing a bridge - a long bridge, long enough that you really can't see the end that you left or the end that you are approaching. You aren't on the solid land on either side of the bridge but you are far enough from the ends that the only thing that you really see is bridge. In that instant, the bridge is everything to you. That's kind of how I feel - like my life before cancer and my life after cancer aren't even visible any more (even if I know they objectively exist) and all I know right now is my life in the midst of the chemotherapy bridge that I am standing on. It's my whole experience right now - side effects and all - and frankly some days it's the only experience I think I will ever have.
That's pretty dark though.
I can't even begin to imagine what it must have been like to be a young sailor or pilot in the Battle of Midway. If I try, really hard, all I come up with is that they must have been very, very scared and focused on the one thing that was trying to kill them in the very moment in which they were reacting, doing their very best to survive no matter the odds. They had been given tools to fight the battle and there were smart people directing the overall plan, but in the end they had to trust their commanders, trust their training and their tools, and above all have faith that they would survive, that they would win the battle. And, despite how hard things have been over the past month, I still have that faith.
I will win this battle.
A dear friend asked how I was doing the other day. I answer these questions with almost brutal honesty now; I told them that while this cycle has not been a walk in the park, it has been much easier than the last one. Midway through my third cycle - about two weeks ago - I felt defeated. I was losing the battle against my side effects and the forces that were fighting the potential cancer in my body were causing unreasonable casualties against the innocent cells in my body. There was one point - it was only for five minutes, but I think I will remember those five minutes for the rest of my life - when I felt like I had surrendered. I was not just losing the battle, I had already lost it. But my army of angels rallied around me led by my amazing wife. She advocated for my care to one of my oncologists and they reduced the dose of fluorouracil that was causing the intolerable GI side effects I was experiencing, plus they added the whole armamentarium of medications that are balancing my side effects to be on the tolerable side of the nasty knife's edge I had been dancing on. My neutrophil count has recovered and was a very respectable 2.69 just prior to my last course of chemotherapy so my bone marrow seems to be holding its own. Even more important than that number, I am happy to report that I am feeling much better than last cycle... even if I still have noticeable and uncomfortable adverse effects from my chemotherapy.
I can weather this battle; there will be no surrender.
The tide of battle has turned. From this point on, my life will get closer to a life without cancer instead of being in the very middle of a life battling cancer. And before too long, my battle with cancer will be part of history rather than my entire experience.
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